We study the application of a tailored quasi-Monte Carlo (QMC) method to a class of optimal control problems subject to parabolic partial differential equation (PDE) constraints under uncertainty: ...the state in our setting is the solution of a parabolic PDE with a random thermal diffusion coefficient, steered by a control function. To account for the presence of uncertainty in the optimal control problem, the objective function is composed with a risk measure. We focus on two risk measures, both involving high-dimensional integrals over the stochastic variables: the expected value and the (nonlinear) entropic risk measure. The high-dimensional integrals are computed numerically using specially designed QMC methods and, under moderate assumptions on the input random field, the error rate is shown to be essentially linear, independently of the stochastic dimension of the problem—and thereby superior to ordinary Monte Carlo methods. Numerical results demonstrate the effectiveness of our method.
The purpose of this study was to report our experience with the free thoracodorsal artery perforator flap for reconstruction of the oropharynx and soft palate in head and neck cancer using a ...retrospective review of the medical charts of all patients undergoing oropharyngeal reconstruction by free thoracodorsal artery perforator flap during the same procedure as cancer resection between January 2011 and April 2013. Evaluation of speech, feeding and the presence of nasal emissions was performed 6 months after treatment in accordance with the Declaration of Helsinki. Nine patients were evaluated. Clear understanding of the patient was reported by the family and the examiner for seven patients, while understanding difficulties were reported for two patients (1 case of flap dehiscence and 1 technical error of flap fixation). The results indicated that, due to its complex anatomy and function, reconstruction of the soft palate remains a delicate procedure. The free thoracodorsal artery perforator flap allows functional soft palate reconstruction, while limiting donor site morbidity.
The-Optimal-Lymph-Flow health IT system (TOLF) is a patient-centered, web-and-mobile-based educational and behavioral health IT system focusing on safe, innovative, and pragmatic self-care strategies ...for lymphedema symptom management. The purpose of this study was to evaluate usability, feasibility, and acceptability of TOLF among the end-user of breast cancer survivors.
Two types of usability testing were completed with 30 breast cancer survivors: heuristic evaluation and end-user testing. Each participant was asked to think aloud while completing a set of specified tasks designed to explicate and freely explore the system features. A heuristic evaluation checklist, the Perceived Ease of Use and Usefulness Questionnaire, and The Post Study System Usability Questionnaire were used to evaluate usability of the system. Open-ended questions were used to gather qualitative data. Quantitative data were analyzed using descriptive statistics and qualitative data were summarized thematically.
Breast cancer survivors were very satisfied with the system: 90% (n=27) rated the system having no usability problems; 10% (n=3) noted minor cosmetic problems: spelling errors or text font size. The majority of participants 96.6% (n=29) strongly agreed that the system was easy to use and effective in helping to learn about lymphedema, symptoms and self-care strategies. Themes from the qualitative data included empowerment, high quality information, loving avatar simulation videos, easy accessibility, and user-friendliness.
This usability study provided evidence on breast cancer survivor's acceptance and highly positive evaluation of TOLF's usability as well as feasibility of using technologically-driven delivery model to enhance self-care strategies for lymphedema symptom management.
•Many breast cancer survivors suffer from daily distressing symptoms related to lymphedema, requires ongoing symptom management.•Health information technology (IT) plays a significant role in improving self-care, patient-clinician communication, and access to health information by patients.•The-Optimal-Lymph-Flow health IT system (TOLF) is a patient-centered, web-and-mobile-based educational and behavioral health IT system focusing on safe, innovative, and pragmatic self-care strategies for lymphedema symptom managemet.•This usability study provided evidence that supports the usefulness of TOLF in terms of breast cancer survivor’s acceptance, user-friendliness, and feasibility of using technologically-driven delivery model to enhance self-care strategies for lymphedema symptom management.
Frondose macroalgae usually harbors a diverse epifaunal community, whereas sediment among the fronds tends to decrease species richness and diversity. The macroalga
Caulerpa racemosa
is found in ...shallow waters and can trap sediment among its stolons. We investigated how the peracarid assemblages from two shores in southeastern Brazil are related to temporal changes in the algal biomass, sediment quantity trapped in
C. racemosa
patches, and organic matter content from adjacent areas. On both shores, there was no significant difference in the algal biomass through time. Algal clumps from Fortaleza retained at least four times more sediment than from Cigarras, and similar temporal trends of sediment retention were observed at both shores. Overall, 47 species of peracarids were identified. Assemblages from Cigarras were richer and more diverse but remained constant through time. Assemblages from Fortaleza had variation in peracarid species and feeding habits through time, with omnivorous and detritivorous species dominating periods of high loads of sediment. While the presence of sediment seems to negatively affect the abundance and diversity of the epifaunal assemblage, it may favor the presence of detritivores, and tube-building species.
Increased numbers of tumour‐associated macrophages correlate with rapid tumour growth and metastasis in tumours. Thus, macrophage depletion has potential as a novel cancer therapy and positive ...responses have been reported in rodent tumour models. To investigate the effectiveness of this approach in dogs with cancer, we evaluated the effects of the macrophage‐depleting agent liposomal clodronate (LC) in dogs with soft‐tissue sarcoma (STS). To this end, we conducted a clinical trial of LC therapy in 13 dogs with STS. Repeated LC administration was well tolerated clinically. Preliminary examination of tumour biopsy sets from 5 of the 13 dogs demonstrated that the density of CD11b+ macrophages was significantly decreased after LC treatment. Circulating concentrations of interleukin‐8 were also significantly reduced. These preliminary studies are the first to suggest that LC can be used as a systemic macrophage‐depleting agent in dogs to reduce numbers of tumour‐associated macrophages.
On the Regiospecificity of Vanadium Bromoperoxidase Martinez, Jennifer S; Carroll, Georgia L; Tschirret-Guth, Richard A ...
Journal of the American Chemical Society,
04/2001, Letnik:
123, Številka:
14
Journal Article
Recenzirano
Vanadium haloperoxidase enzymes catalyze the oxidation of halide ions by hydrogen peroxide, producing an oxidized intermediate, which can halogenate an organic substrate or react with a second ...equivalent of hydrogen peroxide to produce dioxygen. Haloperoxidases are thought to be involved in the biogenesis of halogenated natural products isolated from marine organisms, including indoles and terpenes, of which many are selectively oxidized or halogenated. Little has been shown concerning the ability of the marine haloperoxidases to catalyze regioselective reactions. Here we report the regiospecific bromoperoxidative oxidation of 1,3-di-tert-butylindole by V-BrPO from the marine algae Ascophyllum nodosum and Corallina officinalis. Both enzymes catalyze the regiospecific oxidation of 1,3-di-tert-butylindole in a reaction requiring both H2O2 and Br- as substrates, but which produce the unbrominated 1,3-di-tert-butyl-2-indolinone product exclusively, in near quantitative yield (i.e. one H2O2 consumed per product). By contrast, reactions with the controlled addition of aqueous bromine solution (HOBr = Br2 = Br3 -) produce three monobromo and one dibromo-2-indolinone products, all of which differ from the V-BrPO-catalyzed product. Further, reactivities of 1,3-di-tert-butyl-2-indolinone with both aqueous bromine and V-BrPO differ significantly and shed light onto the possible nature of the oxidizing intermediate. This is the first example of a regiospecific bromination by a vanadium haloperoxidase and further extends their usefulness as catalysts.
Background: Flow cytometry has been used to detect anti‐red blood cell (RBC) antibodies in dogs with immune‐mediated hemolytic anemia (IMHA), but the prevalence of anti‐RBC antibodies in anemic and ...nonanemic dogs with a variety of different diseases has not been assessed previously.
Hypothesis: We hypothesized that anti‐RBC antibodies would be more common in anemic dogs and in dogs with immune‐mediated disorders and cancer.
Animals: Blood samples from 292 dogs were analyzed prospectively by flow cytometry for anti‐RBC antibodies.
Methods: Blood samples from 147 anemic and 145 nonanemic dogs were evaluated by flow cytometry to detect surface‐bound immunoglobulin (Ig) G and IgM antibodies on RBC. Disease associations with RBC antibodies were determined, as was the correlation between disease status and the percentage of Ig+ RBC. The specificity and sensitivity of flow cytometry and clinical variables for the diagnosis of IMHA were compared by Bayesian analysis.
Results: Anemic dogs were significantly more likely to be positive for anti‐RBC antibodies (IgG, IgM, or both) than nonanemic dogs. Anemic dogs also had significantly higher percentages of Ig+ RBC than nonanemic dogs, whereas dogs with IMHA had significantly higher percentages of Ig+ RBC than dogs with all other diseases. Dogs with IMHA, infectious diseases, and immune‐mediated thrombocytopenia were significantly more likely to have anti‐RBC antibodies than dogs with other medical or surgical diseases.
Conclusions: Anemic dogs with immune‐mediated diseases and infectious diseases were at the highest risk for the development of anti‐RBC antibodies, and flow cytometry for the detection of IgG on RBC was highly sensitive and specific for the diagnosis of IMHA.
Oncotype DX, a 21-gene-array analysis, can guide chemotherapy treatment decisions for women with ER+ tumors. Of 225 ER+ women participating in a patient assistance trial, 23% underwent Oncotype DX ...testing: 31% of whites, 21% of blacks, and 14% of Hispanics (P=0.04) were tested. Only 3 white women were treated at municipal hospitals and none was tested. 3% of women treated in municipal hospital as compared to 30% treated at tertiary referral centers were tested (P=0.001). Within tertiary referral centers, there was no racial difference in testing: 32% of whites, 29% of blacks, and 19% of Hispanics (P=0.25). Multivariate analysis (model c-statistic = 0.76; P<0.0001) revealed that women who underwent testing were more likely to have stage 1B (RR=1.70; 95% CI: 1.45–1.85) and to be treated after 2007 (RR=1.34; 95% CI: 1.01–1.65) and less likely to be treated at a municipal hospital (RR=0.20; 95% CI: 0.04–0.94). Women treated at municipal hospitals were less likely to undergo testing resulting in a misleading racial disparity that is driven by site of care. As Oncotype DX can reduce overuse of chemotherapy, it is imperative to expand testing to those who could benefit from yet experience underuse of this test, namely, women treated at safety net hospitals. This trial is registered with NCT00233077.
Oncologic outcomes with nipple-sparing mastectomy continue to be established. The authors examine oncologic trends, outcomes, and risk factors, including tumor-to-nipple distance, in therapeutic ...nipple-sparing mastectomies.
Demographics, outcomes, and overall trends for all nipple-sparing mastectomies performed for a therapeutic indication from 2006 to 2017 were analyzed. Oncologic outcomes were investigated with specific focus on recurrence and associated factors, including tumor-to-nipple distance.
A total of 496 therapeutic nipple-sparing mastectomies were performed, with an average follow-up time of 48.25 months. The most common tumor types were invasive carcinoma (52.4 percent) and ductal carcinoma in situ (50.4 percent). Sentinel lymph node sampling was performed in 79.8 percent of nipple-sparing mastectomies; 4.1 percent had positive frozen sentinel lymph node biopsy results, whereas 15.7 percent had positive nodal status on permanent pathologic examination. The most common pathologic cancer stage was stage IA (42.5 percent) followed by stage 0 (31.3 percent). The rate of local recurrence was 1.6 percent (n = 8), and the rate of regional recurrence was 0.6 percent (n = 3). In all, 171 nipple-sparing mastectomies had magnetic resonance imaging available with which to assess tumor-to-nipple distance. Tumor-to-nipple distance of 1 cm or less (25.0 percent versus 2.4 percent; p = 0.0031/p = 0.1129) and of 2 cm or less (8.7 percent versus 2.0 percent; p = 0.0218/p = 0.1345) trended to higher rates of locoregional recurrence. In univariate analysis, tumor-to-nipple distance of 1 cm or less was the only significant risk factor for recurrence (OR, 13.5833; p = 0.0385). No factors were significant in regression analysis.
In early stage and in situ breast carcinoma, therapeutic nipple-sparing mastectomy appears oncologically safe, with a locoregional recurrence rate of 2.0 percent. Tumor-to-nipple distances of 1 cm or less and 2 cm or less trended to higher recurrence rates.
Risk, III.
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